论文部分内容阅读
目的:评介AFP、B超、彩色多普勒血流图像(CDFI)、CT、MRI、DSA和术中B超(IOUS)对肝癌的诊断意义。方法:对病理诊断并作AFP、B超(US)、CT扫描及部分其他影像检查的168例原发性肝癌(HCC)的临床诊断进行分析。结果:AFP大于正常参考值者101例(60.1％)。6种影像对肝占位病变的总检出率为96.4％。US、CT、CDFI、MRI、DSA和IOUS诊断与病理诊断符合率分别为:89.3％(150/16R)、88.1％(148/168)、93.7％(15/16)、100％(6/6)、85.7％(6/7)和100％(11/11)。结论:①US与CT对AFP阴性及低浓度阳性HCC具有一定的独立诊断价值,在US及AFP检查受限时,CDFI及IOUS对小肝癌有进一步诊断意义;②AFP增高和/或有肝占位病变,对多数病例具有诊断意义,但对不易诊断病例,特别是AFP阴性或低浓度增高小肝癌,不易与其他非癌性肝占位病变鉴别,必须长期动态观察,直到排除或确立诊断为止。
Objective: To evaluate the diagnostic value of AFP, B-ultrasonography, color Doppler flow imaging (CDFI), CT, MRI, DSA, and intraoperative ultrasound (IOUS) for liver cancer. Methods: The clinical diagnosis of 168 cases of primary liver cancer (HCC) with pathologic diagnosis and AFP, B-US (US), CT scan and some other imaging examinations were analyzed. Results: 101 patients (60.1%) had AFP greater than normal reference value. The total detection rate of liver lesions in 6 types of images was 96.4%. The coincidence rates of diagnosis and pathological diagnosis of US, CT, CDFI, MRI, DSA, and IOUS were: 89.3% (150/16R), 88.1% (148/168), 93.7% (15/16), 100% (6/6). ), 85.7% (6/7) and 100% (11/11). Conclusion: 1 US and CT have certain independent diagnostic value for AFP-negative and low-concentration positive HCC. When US and AFP examination are limited, CDFI and IOUS have further diagnostic significance for small hepatocellular carcinoma; 2AFP increase and/or liver space-occupying lesions , For most cases with diagnostic significance, but difficult to diagnose cases, especially AFP-negative or low-increased small hepatocellular carcinoma, not easy to identify with other non-cancerous liver-occupying lesions, must be long-term dynamic observation until the diagnosis is eliminated or established.